You need to get calories from somewhere, should it be from carbohydrate or fat?

Thursday, November 05, 2009

Dr Uffe Ravnskov MD PhD interview

Just a brief aside, here is part of an interview with Uffe Ravnskov MD PhD which neatly summarises the situation in Sweden at the moment. I'll link to the full text, which is much more wide ranging, when I've read through it all.

Interviewer: Do you think mainstream medicine will ever relinquish its view that elevated cholesterol causes heart disease and that statins are the magic bullet?

Dr Ravnskov: I hope so. The failures of the most recent statin trials has been commented by several journalists in the major US newspapers. In Sweden a revolution is going on. Here, a general practitioner treated her own obesity successfully by eating a low-carbohydrate diet with a high content of animal fat. When she advised her obese and diabetic patients to do the same, she was reported to the National Board of Health and Welfare for malpractice. After a two-year-long investigation she was acquitted, as her treatment was considered to be in accord with scientific evidence. At the same time, the Board dismissed two experts, who had been appointed for updating the dietary recommendations for diabetics, because it came up that they were sponsored by the food industry. Instead the Board has asked independent researchers to review the scientific literature.

The subject has gained general attention due to a number of radio and television shows, where critical experts including myself have discussed the issue with representatives of the official view. Most important, thousands of patients have experienced themselves that by doing the opposite as recommended by the current guidelines they have regained their health. The effect has been that the sales of butter, cream and fat milk are increasing in Sweden after many years of decline, and a recent poll showed that a majority of Swedish people today think that the best way of losing weight is by a low-carbohydrate, fat-rich diet.

Further progress was achieved this spring. Several times colleagues of mine and also myself have asked the Swedish Food Administration for the scientific basis of their warnings against saturated fat. We have been met with the argument that there are thousands of such studies, or by referrals to the WHO guidelines or the Nordic Nutrition Recommendations. As the main argument in the latter two is that saturated fat raises cholesterol we were not satisfied with their answer and finally the Food Administration published a list with 72 studies that they claimed were in support of their view on saturated fat and twelve that were not.

We scrutinized the lists and found that only two of the 72 studies supported their standpoint; eleven studies did not concern saturated fat at all, and the unsupportive list was incomplete, to put it mildly. We published a short report with our comments to these lists in the Swedish medical journal Dagens Medicin. A response from the Food Administration appeared seven weeks later in which they pointed out that their recommendations were directed to healthy people, not to patients. They maintained that they were based on solid scientific evidence without mentioning anything about saturated fat and without answering our critical comments.

But this is not all. Earlier this year Sachdeva et al reported that the mean cholesterol in 137,000 patients with acute myocardial infarction was lower than normal. As usual, the authors didn’t understand their own findings, but concluded that cholesterol should be lowered even more. A few months later Al-Mallah et al. came up with the same result and conclusion, although they also reported that three years later, mortality was twice as high among those who had been admitted with the lowest cholesterol.

These results created a fierce debate in one of the major Swedish newspapers. It was opened by ninety-one-year old Lars Werkö, the ‘Grand Old Man’ in Swedish medical science, retired professor in internal medicine and former head of The Swedish Council on Technology Assessment in Health Care, together with Tore Scherstén, retired professor in surgery and former secretary of the Swedish Medical Research Council. “Now it is time to sack the cholesterol hypothesis and to investigate the reason of this scientific breakdown” they wrote. They also criticized American researchers in AHA and NHLBI and their followers for sloppy and fraudulent science.

They were of course attacked by two professors and representatives of the current view, but none of them came up with any substantial evidence, only by personalities.

2) Peter, I gather that your total chol is ~8mmol/L. That level would give my GP & Endo apoplexies trying to force-feed me statins (my last total chol result was ~7 due to excessive comfort eating. It's usually ~6).

Have you had a NMR lipoprotein profile or CAC heart scan?

3) LeonRover: You can make links clickable by using < a href='url'>Title< /a> (remove the first and last space to make it work).

My CAC Agatston score was 7 a year ago but the cost of the combined trainfare to London and a repeat scan are out of the question at the moment... NMR lipoproteins interest me less than CAC, the disease process is more interesting than lipid surrogates to a cholesterol sceptic! If you can actually get them in the UK, I'm not so sure about that.

Peter

CT is available in Glasgow quite cheaply (was half price in September!) but it's a hell of a dose of radiation and the scoring system seems to be different. I'd like to use the same machine as last time.

Thanks for the link, I gathered the number was reasonable but zero is better. Currently I go for normoglycaemia w/o hyperinsulinaemia for my best bet for minimising progress. My vitamin K tends to be bacterial from yogurt and I'm not at all sure how useful this might be...

What news. How big is the National Board of Health and Welfare? Is it like the AHA or NIH or even a governmental agency? If so, then it's like a complete reversal of conventional dogma from the top. Only, since what did the trick was the "treatment was considered to be in accord with scientific evidence", then it isn't dogma at all, it's the truth.

Maybe the previous dogma was said to be based on scientific evidence, but statistics from the Seven Countries paper is merely accounting. Incomplete, immature and outright flawed accounting. I have to wonder how many penalties Ancel had to pay for fudging his income tax forms.

Hi Peter,This is fascinating!My theory is that the present change in the paradigm (in Poland and Sweden at first) has been caused more by a different generation of thinking people rather than any one scientist managing to convince his peers of the truth.

The current generation of non-scientific technology-inept consensus-seekers, cholesterol-fighting low fat followers is giving way to new people. I welcome this, though I will miss the fun of being a "heretic". May have to switch to other heresies, if there are going to be any left. 8-:) Stan

Socialstyrelsen (National Board of Health and Welfare) is a govermnet agency. "The board has a very wide range of activities and many different duties within the fields of social services, health and medical services, environmental health, communicable disease prevention and control and epidemiology. The Government determines the policy guidelines for our work."

About Me

I am Petro Dobromylskyj, always known as Peter. I'm a vet, trained at the RVC, London University. I was fortunate enough to intercalate a BSc degree in physiology in to my veterinary degree. I was even more fortunate to study under Patrick Wall at UCH, who set me on course to become a veterinary anaesthetist, mostly working on acute pain control. That led to the Certificate then Diploma in Veterinary Anaesthesia and enough publications to allow me to enter the European College of Veterinary Anaesthesia and Analgesia as a de facto founding member. Anaesthesia teaches you a lot. Basic science is combined with the occasional need to act rapidly. Wrong decisions can reward you with catastrophe in seconds. Thinking is mandatory.
I stumbled on to nutrition completely by accident. Once you have been taught to think, it's hard to stop. I think about lots of things. These are some of them.

Organisation (or lack of it)!

The "labels" function on this blog has been used to function as an index and I've tended to group similar subjects together by using labels starting with identical text. If they're numbered within a similar label, start with (1). The archive is predominantly to show the posts I've put up in the last month, if people want to keep track of recent goings on. I might change it to the previous week if I ever get to time to put up enough posts in a week to justify it. That seems to be the best I can do within the limits of this blogging software!